“Always use all the information that is available to you”

Common clinical issues within the AOP clinical negligence team’s caseload were discussed during the 100% Optical presentation Definitely, maybe?

AOP clinical and professional director, Dr Peter Hampson, shared that in 2023–2024 around 25 million sight tests were performed in the UK.

During that time period, the General Optical Council (GOC) triaged 405 complaints and opened 132 investigations.

“Generally speaking, you’re all doing a pretty good job,” he shared.

Hampson explained that the reason that the AOP focuses on providing education sessions in this area is that, despite the relatively low number of complaints, there is a significant effect on the professionals involved.

He shared that the median period it takes to progress to a GOC hearing is 72 weeks – during which time the optometrists subject to complaint may face a significant amount of stress.

AOP solicitor, David Bowes, provided an overview of claims the AOP supported members with in 2024.

He shared that claims relating to retinal detachments were the most common type of claim.

Bowes added that growth of different forms of imaging technology in optometric practice, including optical coherence tomography, have contributed to this trend.

He highlighted that in 2024 claims relating to care of keratoconus patients were the second most common claim type, while claims relating to the clinical care of glaucoma patients were also common.

Claims related to age-related macular degeneration, cataracts and incorrect prescriptions typically featured in the AOP clinical negligence team’s 10 most common claim types.

Explaining key differences between clinical negligence cases and GOC cases, Hampson shared that the GOC, as the regulator of optometrists, can place sanctions on optometrists – such as suspension or erasure. However, the GOC cannot arrange refunds or reward damages.

Hampson highlighted that, in contrast, clinical negligence cases can result in the payment of compensation to patients but cannot stop optometrists from practising.

Clinical negligence aims to correct a situation where a party has been wronged by an error or mistake.

“Clinical negligence is not a punitive process,” he said.

AOP head of clinical negligence, Efa Schmidt, outlined the concept of causation in clinical negligence cases, which aims to establish whether a breach of duty resulted in an injury or loss to a patient.

When establishing whether a breach occurred, the optometrist’s actions are assessed against the steps that would be taken by a reasonably competent optometrist in the same set of circumstances.

“It’s really important that you follow the guidance in totality,” Schmidt shared.

“If the guidance has been followed, we are able to much more successfully defend a claim,” she said.

Hampson outlined the difference between the specificity and sensitivity of tests. He explained how an understanding of these concepts can have useful applications within optometric practice.

For example, when testing for a relatively uncommon disease, a certain proportion of false positives is to be expected.

Hampson shared that this is where repeat reading schemes can help practitioners to tread the tightrope between under-referral and over-referral.

Discussing the role of artificial intelligence (AI) in eye care, Hampson shared that this technology has the same challenges around sensitivity and specificity.

“It will make the same mistakes that humans make. That’s why, when we think about AI, we should consider this technology as a second opinion,” he said.

As part of his closing remarks, Hampson emphasised the importance of  taking due care with the information that is revealed through history and symptoms.

“Always use all the information that is available to you,” he highlighted.